Extended Data Fig. 4. Study design of the post-deployment evaluation of management recommendations’ quality and level of empathy.

a, In the PCP + DeepDR-LLM arm, the DeepDR-LLM system was integrated into the clinical workflow. Initially, PCPs and DeepDR-LLM gave management recommendations independently. The recommendations given by DeepDR-LLM was automatically generated from electronic health systems, by extracting and analyzing the fundus images, medical history, physical examinations, and laboratory tests. Subsequently, PCPs edited their recommendations in text form by taking DeepDR-LLM’s recommendations into account. b, For participants in the PCP + DeepDR-LLM arm, they filled out a questionnaire investigating their opinions on three recommendations at the 4-week follow-up. Evaluators, including endocrinologists and surveyed participants, ranked these three recommendations and judged both ‘the quality of information provided’ (very poor, poor, acceptable, good, or very good) and ‘the empathy or bedside manner provided’ (not empathetic, slightly empathetic, moderately empathetic, empathetic, and very empathetic).